Provider Demographics
NPI:1023253796
Name:CHIEDU, IFEANYI HYACINTH
Entity type:Individual
Prefix:MR
First Name:IFEANYI
Middle Name:HYACINTH
Last Name:CHIEDU
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:HYACINTH
Other - Middle Name:MADUEKE
Other - Last Name:CHIEDU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:712 SUNNYSIDE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-3421
Mailing Address - Country:US
Mailing Address - Phone:713-694-0051
Mailing Address - Fax:713-694-4711
Practice Address - Street 1:712 SUNNYSIDE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-3421
Practice Address - Country:US
Practice Address - Phone:713-694-0051
Practice Address - Fax:713-694-4711
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker